At CapeRay we have been studying the images that were recently gathered during our clinical trial of both healthy volunteers and patients with confirmed breast cancer. Even though these images can be large – a single file from automated breast ultrasound (ABUS) can be two to three gigabytes in size – we have been able to utilize the Cloud to share our data with clinicians around the world. There are services such as Apple’s iCloud and Hightail (previously known as YouSendIt) and we have chosen to use the ubiquitous Dropbox although there are other excellent options described by Cloudwards.

The Swedish company Sectra has just released a product called CloudFlex that is specifically designed to address the needs of low-volume mammography clinics by providing them with the tools required to manage screening exams more efficiently. According to vice president Kevin Collins, “There are a number of smaller organizations, especially OB/GYN practices that are thinking of offering mammography now. The only thing holding them back from offering screening mammograms is the ability to get those exams read on a timely basis.” Telemammography thus has the potential to enable a single subspecialty radiologist to serve multiple low-volume sites.

Collins argues that CloudFlex doesn’t just enhance access, it also provides the opportunity to improve patient care: “Now patients don’t have to make an extra, potentially lengthy trip to get the exam done – they can combine it with another healthcare appointment.” While there are obvious benefits to teleradiology, there are some concerns that were highlighted in a position statement published this week by the Royal College of Radiologists (RCR) in the UK.

Dr Giles Maskell, president of the RCR has said, “The reporting of patients’ images by a local radiologist who can speak directly to other clinicians is the best for patients. Remote reporting or teleradiology can provide a useful alternative when local services are overstretched. However, patients deserve the reassurance that quality and safety are always the first priority, whoever reports their images.”

Among the 13 key principles put forward by the RCR are included these three: patients should be clearly informed if their images are to be read by a radiologist working outside the facility where the images were acquired; the diagnosing radiologist should have access to the patient’s previous images and clinical history; and secondary incentives – financial or otherwise – must be subsidiary to the well-being of the patient. So, for that diagnosis in the Dropbox, money will always be an issue.